Specialista in Ortopedia Pediatrica
Flexible metatarsus adductus
Home Exercise Program
Not every exercise listed here is suitable for every child: the selection is individual and is defined during the consultation.
1.Forefoot abduction stretch (main maneuver)
Stretches the tight medial structures: movement comes from the forefoot, never from the ankle
Baby supine and relaxed (ideally during a diaper change). One hand stabilises the hindfoot: thumb and index wrap the heel and midfoot and hold them STILL. The other hand grasps the forefoot at the metatarsal heads and slowly moves it outward (abduction), straightening the "bean-shaped" outer border. The pivot is the midfoot: the ankle does NOT move and the heel must not rotate. The stretch is gentle and progressive, never jerky. Baby may protest because the foot is held, but there must be no pain.
Hold 20-30 seconds, 5 reps per foot, at every diaper change (5-6 times daily)
2.Active outer border stimulation
Activates the peroneal muscles that open the foot outward
With baby awake, stroke or tickle the OUTER border of the foot with a finger, from heel toward the fifth toe. The stimulus triggers the peroneal muscles: the foot fans outward and lifts. This is the baby's own active correction, complementary to the passive stretch. Repeat with a soft brush or fabric toy.
10-15 strokes per foot, several times a day during play
3.Preparatory massage and toe mobilization
Softens the tissues before stretching and keeps the joints mobile
Before each session, massage the whole foot for 1-2 minutes with cream or oil: dorsum, sole, medial border (where tissues are tightest) and calf. Then mobilise each toe individually: flexion, extension, gentle spreading. A warm, soft foot corrects better and the baby tolerates the next maneuver more easily.
1-2 minutes before each stretching session
4.Positioning, clothing and footwear
Avoids positions that keep the forefoot adducted around the clock
Let the baby be barefoot often and free of tight covers so they can kick freely. Avoid rompers, socks and sleep-sacks that squeeze the forefoot: toes need plenty of room. Do not let the baby sleep prone with the feet tucked under (a position that increases adduction): sleep is always supine. Once walking, use straight-last shoes (no inward curve of the sole), never narrow-toed shoes.
Every day, all day: barefoot time and checking clothing and shoes
RED FLAGS - When to stop and contact the doctor immediately
Stop the exercises immediately and contact the specialist (or go to the emergency department if severe) if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
- Fever, redness or warmth of the joint, or inability to bear weight
In case of doubt, always prefer a check-up over continuing the exercises.
Dott. Daniele Priano
Ortopedia Pediatrica - ASST Gaetano Pini-CTO
ortopediaevolutiva.com • 26/08/2026
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MioDottoreBefore You Start
Who is this guide for?
Newborns with metatarsus adductus. Gentle mobilizations performed by parents during diaper changes.
What you need
No specific equipment. Clean hands, calm environment, relaxed baby.
Suggested frequency
Usually 1-2 times daily, as directed during the visit. Consistency is more important than intensity.
Common mistakes to avoid
- •Performing exercises too quickly without control
- •Pushing beyond the pain threshold
- •Skipping days or doing occasional very long sessions
- •Not warming up before strengthening exercises
⚠️ Red flags — when to stop and contact the doctor immediately
Stop exercises immediately and contact the specialist if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
Detailed Exercises
- 1
Forefoot abduction stretch (main maneuver)
Stretches the tight medial structures: movement comes from the forefoot, never from the ankle
Baby supine and relaxed (ideally during a diaper change). One hand stabilises the hindfoot: thumb and index wrap the heel and midfoot and hold them STILL. The other hand grasps the forefoot at the metatarsal heads and slowly moves it outward (abduction), straightening the "bean-shaped" outer border. The pivot is the midfoot: the ankle does NOT move and the heel must not rotate. The stretch is gentle and progressive, never jerky. Baby may protest because the foot is held, but there must be no pain.
Hold 20-30 seconds, 5 reps per foot, at every diaper change (5-6 times daily) - 2
Active outer border stimulation
Activates the peroneal muscles that open the foot outward
With baby awake, stroke or tickle the OUTER border of the foot with a finger, from heel toward the fifth toe. The stimulus triggers the peroneal muscles: the foot fans outward and lifts. This is the baby's own active correction, complementary to the passive stretch. Repeat with a soft brush or fabric toy.
10-15 strokes per foot, several times a day during play - 3
Preparatory massage and toe mobilization
Softens the tissues before stretching and keeps the joints mobile
Before each session, massage the whole foot for 1-2 minutes with cream or oil: dorsum, sole, medial border (where tissues are tightest) and calf. Then mobilise each toe individually: flexion, extension, gentle spreading. A warm, soft foot corrects better and the baby tolerates the next maneuver more easily.
1-2 minutes before each stretching session - 4
Positioning, clothing and footwear
Avoids positions that keep the forefoot adducted around the clock
Let the baby be barefoot often and free of tight covers so they can kick freely. Avoid rompers, socks and sleep-sacks that squeeze the forefoot: toes need plenty of room. Do not let the baby sleep prone with the feet tucked under (a position that increases adduction): sleep is always supine. Once walking, use straight-last shoes (no inward curve of the sole), never narrow-toed shoes.
Every day, all day: barefoot time and checking clothing and shoes
Frequently Asked Questions
Does metatarsus adductus correct on its own?
Most flexible cases correct spontaneously within the first 1-2 years. Mobilizations accelerate correction. If the foot is rigid or doesn't improve by 6-8 months, additional treatment (corrective casts) may be needed.
How do I know if metatarsus adductus is flexible or rigid?
If you can correct the deformity with light pressure (foot straightens easily), it's flexible and mobilizations are the indicated treatment. If the foot resists correction, it's rigid and specialist evaluation for possible casts is needed.